The proposed project will focus on alleviating severe pain in hospitalized burn patients using novel combinations of virtual reality and psychological interventions (hypnosis), as well as offering a comprehensive longitudinal follow-up study on the psychological outcome of burn patients. This proposal is for a competitive renewal of an NIH RO1 level grant and will represent the fourth cycle of funding (the current cycle of funding is scheduled to end July 1, 2003). Four studies are proposed. Study 1 will test a newly developed approach to delivering hypnosis though immersive reality technology. Study 2 will compare high technology and low technology virtual reality distraction delivered though a "water friendly" delivery system. Both Studies 1 & 2 will be random controlled studies conducted with hospitalized burn patients undergoing dressing changes. Study 3 will investigate the interaction between hypnotic suggestibility and virtual reality in controlling thermally induced experimental pain in college students, again using a randomized controlled design. Study 4 will be the most comprehensive longitudinal study conducted on the psychological and physical outcome of adult burn survivors conducted to date. The proposed project is significant in that it seeks to test the efficacy of interventions to increase pain control and decrease stress in a trauma population, better understand the mechanism of action of these interventions, and better understand the long term consequences of improved pain control. The innovative techniques proposed should be applicable to patients suffering pain from multiple other etiologies.